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Unfolding the Mystery of Autoimmunity: The Environmental Determinants of Diabetes in the Young (TEDDY) Study

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posted on 2025-04-24, 00:10 authored by Marian Rewers, Daniel Agardh, Suzanne Bennett Johnson, Ezio Bonifacio, Helena Elding Larsson, Patricia Gesualdo, William Hagopian, Michael J. Haller, Heikki Hyöty, Randi Johnson, Richard McIndoe, Eoin McKinney, Jessica Melin, Åke Lernmark, Richard E. Lloyd, Kristian F. Lynch, Jill M. Norris, Stephen S. Rich, Roswith Roth, Desmond Schatz, Jorma Toppari, Eric Triplett, Kendra Vehik, Suvi M. Virtanen, Anette-G. Ziegler, Jeffrey P. Krischer

In 2025, the National Institute for Diabetes, Digestive and Kidney Diseases (NIDDK) at the National Institutes of Health celebrates 75 years of leadership in diabetes research. The NIDDK serves people of the United States affected by or at risk for many chronic diseases, including diabetes and other endocrine, metabolic and digestive disorders by funding innovative research to develop better treatment, prevention, and cure for these conditions. Autoimmunity that leads to type 1 diabetes, celiac or thyroid autoimmunity affects one in twenty children and adolescents in the USA. While treatments are available, prevention of these common autoimmune diseases has been elusive due to poor understanding of the environmental causes and their interactions with common predisposing or protective genetic variants.

In 2002, the NIDDK established The Environmental Determinants of Diabetes in the Young (TEDDY) consortium to advance understanding of the causes and the natural history of type 1 diabetes and other autoimmune diseases. The overarching goal of TEDDY is to inform novel approaches to primary prevention of autoimmunity. This large international prospective birth cohort study has collected standardized information concerning candidate environmental exposures and serial blood, stool, nasal swab and other biosamples and created a central repository of data and biologic samples for hypothesis-based research. This review summarizes TEDDY’s major contributions to our understanding of environmental triggers, drivers, modifiers, and gene-environment interactions leading to type 1 diabetes.

Funding

The TEDDY Study is funded by U01 DK63829, U01 DK63861, U01 DK63821, U01 DK63865, U01 DK63863, U01 DK63836, U01 DK63790, UC4 DK63829, UC4 DK63861, UC4 DK63821, UC4 DK63865, UC4 DK63863, UC4 DK63836, UC4 DK95300, UC4 DK100238, UC4 DK106955, UC4 DK112243, UC4 DK117483, U01 DK124166, U01 DK128847, and Contract No. HHSN267200700014C from the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), National Institute of Allergy and Infectious Diseases (NIAID), Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institute of Environmental Health Sciences (NIEHS), Centers for Disease Control and Prevention (CDC), and Breakthrough T1D (formerly JDRF). This work is supported in part by the NIH/NCATS Clinical and Translational Science Awards to the University of Florida (UL1 TR000064) and the University of Colorado (UL1 TR002535). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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    Diabetes Care

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    Type 1 DiabetesEtiologyAutoimmune Diseases/DisordersEnvironmental TriggersPreclinicalCeliac Disease

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